eprintid: 10044023 rev_number: 27 eprint_status: archive userid: 608 dir: disk0/10/04/40/23 datestamp: 2018-02-23 16:17:43 lastmod: 2021-09-26 23:04:44 status_changed: 2018-02-23 16:17:43 type: article metadata_visibility: show creators_name: Taylor, PN creators_name: Sinha, N creators_name: Wang, Y creators_name: Vos, SB creators_name: de Tisi, J creators_name: Miserocchi, A creators_name: McEvoy, AW creators_name: Winston, GP creators_name: Duncan, JS title: The impact of epilepsy surgery on the structural connectome and its relation to outcome ispublished: inpress subjects: UCH divisions: UCL divisions: B02 divisions: C07 divisions: D07 divisions: F81 divisions: B04 divisions: C05 divisions: F48 keywords: Connectome, Network, Temporal lobe epilepsy, Surgery, Machine learning, Support vector machine (SVM) note: © 2018 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) abstract: BACKGROUND: Temporal lobe surgical resection brings seizure remission in up to 80% of patients, with long-term complete seizure freedom in 41%. However, it is unclear how surgery impacts on the structural white matter network, and how the network changes relate to seizure outcome. METHODS: We used white matter fibre tractography on preoperative diffusion MRI to generate a structural white matter network, and postoperative T1-weighted MRI to retrospectively infer the impact of surgical resection on this network. We then applied graph theory and machine learning to investigate the properties of change between the preoperative and predicted postoperative networks. RESULTS: Temporal lobe surgery had a modest impact on global network efficiency, despite the disruption caused. This was due to alternative shortest paths in the network leading to widespread increases in betweenness centrality post-surgery. Measurements of network change could retrospectively predict seizure outcomes with 79% accuracy and 65% specificity, which is twice as high as the empirical distribution. Fifteen connections which changed due to surgery were identified as useful for prediction of outcome, eight of which connected to the ipsilateral temporal pole. CONCLUSIONS: Our results suggest that the use of network change metrics may have clinical value for predicting seizure outcome. This approach could be used to prospectively predict outcomes given a suggested resection mask using preoperative data only. date: 2018-01-31 date_type: published official_url: https://doi.org/10.1016/j.nicl.2018.01.028 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green article_type_text: Journal Article verified: verified_manual elements_id: 1535740 doi: 10.1016/j.nicl.2018.01.028 lyricists_name: de Tisi, Jane lyricists_name: Duncan, John lyricists_name: McEvoy, Andrew lyricists_name: Miserocchi, Anna lyricists_name: Vos, Sjoerd lyricists_name: Winston, Gavin lyricists_id: JDETI66 lyricists_id: JSDUN52 lyricists_id: AWMCE45 lyricists_id: AMISE50 lyricists_id: SVOSX19 lyricists_id: GWINS71 actors_name: Smith, Daniel actors_id: DSMIT53 actors_role: owner full_text_status: public publication: NeuroImage: Clinical volume: 18 pagerange: 202-214 issn: 2213-1582 citation: Taylor, PN; Sinha, N; Wang, Y; Vos, SB; de Tisi, J; Miserocchi, A; McEvoy, AW; ... Duncan, JS; + view all <#> Taylor, PN; Sinha, N; Wang, Y; Vos, SB; de Tisi, J; Miserocchi, A; McEvoy, AW; Winston, GP; Duncan, JS; - view fewer <#> (2018) The impact of epilepsy surgery on the structural connectome and its relation to outcome. NeuroImage: Clinical , 18 pp. 202-214. 10.1016/j.nicl.2018.01.028 <https://doi.org/10.1016/j.nicl.2018.01.028>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10044023/1/1-s2.0-S2213158218300287-main%283%29.pdf